When can physical distancing be relaxed? A health production function approach for COVID-19 control policy

Abstract

Background To assess if physical distancing measures to control the COVID-19 pandemic can be relaxed, one of the key indicators used is the reproduction number R. Many developing countries, however, have limited capacities to estimate R accurately. This study aims to demonstrate how health production function can be used to assess the state of COVID-19 transmission and to determine a risk-based relaxation policy. Methods The author employs a simple “bridge” between epidemiological models and production economics to establish the cumulative number of COVID-19 cases as a short-run total product function and to derive the corresponding marginal product, average product, and production elasticity. Three crucial dates defining the states of transmission, labelled red, yellow, and green zones, are determined. Relaxation policy is illogical in the “red zone” and is not recommended in the “yellow zone”. In the “green zone”, relaxation can be considered. The Bayesian probability of near term’s daily cases meeting a policy target is computed. The method is applied to France, Germany, Italy, the UK, and the US, and to Indonesia as an example of application in developing countries. Results This study uses data from the WHO COVID-19 Dashboard, beginning from the first recording date for each country until February 28, 2021. As of June 30, 2020, France, Germany, Italy, and the UK had arrived at the “green zone” but with a high risk of transmission re-escalations. In the following weeks, their production elasticities were rising, giving a signal of accelerated transmissions. The signal was corroborated by these countries’ rising cases, making them leaving the “green zone” in the later months. By February 28, 2021, the UK had returned to the “green zone”, France, Germany, and Italy were still in the “yellow zone”, while the US reached the “green zone” at a very high number of cases. Despite being in the “red zone”, Indonesia relaxed its distancing measures, causing a sharp rise of cases. Conclusions Health production function can show the state of COVID-19 transmission. A rising production elasticity gives an early warning of transmission escalations. The elasticity is a useful parameter for risk-based relaxation policy.

Formulating a Health Sustainable Development Policy: How the Actors Handling the COVID-19 in Indonesia

“…Figure 7. Indonesian Government Policy Framework in Control Source: (Hidayat, 2020;Wibowo, 2021) In controlling COVID-19, the Indonesian government formulates sustainable development policies in the health sector, which can be seen based on Figure 7. The government's readiness for sustainable development in the health sector by doing; 1) Health laboratories for COVID-19 examinations in Indonesia are prepared for 422 laboratories to check the results of COVID-19 tests (Ministry of Health.…”

“…Republic of Indonesia., 2021); 3) Implementation of Health Quarantine, efforts to prevent and ward off the exit or entry of diseases and risks that threaten public health that have the potential to cause public health emergencies; 4) Telemedicine services, as health services carried out by health workers using information and communication technology to diagnose, prevent, treat, or evaluate patients' health conditions, and continuing education of health service providers for the benefit of improving individual or community health (Hidayat, 2020;Wibowo, 2021); 5) Availability of Human Data Sources by adding health workers more than 13,000 health human resources consisting of volunteers, healthy archipelago, and internship program participants have been placed in health facilities to support health services in controlling COVID-19 (Scope et al, 2011); 6) COVID-19 Recording and Reporting System, by integrating information and communication technology to facilitate contact tracing and monitoring; 7) Implementation of health protocols and social distancing as an effort to prevent the transmission of COVID-19. In addition, the Indonesian government also has prepared budget incentives to support the development of resources and infrastructure in the health sector to control COVID-19 (Hidayat, 2020;Wibowo, 2021). The Indonesian government has made various efforts to control COVID-19, starting from regulatory policies, budgets, infrastructure readiness, and resources in the health sector in Indonesia.…”

“…This study uses a qualitative research method with a descriptive approach, where the authors analyze in depth by identifying and classifying policies made in controlling COVID-19. In addition, the author also analyzes the role of the actors involved in controlling COVID-19 because the actors involved are the subject of the implementation of the COVID-19 control policy (Amirudin et al, 2021;Wibowo, 2021). So, that actors have a vital role in the implementation of COVID-19 control policies.…”

The Political Economy of Sustainable Development in Indonesia

“…This relaxation was taken despite the fact that Indonesia's daily cases were still on the rise and the country's COVID-19 transmission was still on an upward state as shown by its health production function. Throughout June 2020 Indonesia's COVID-19 production elasticity was shown to vary between 2.12 and 3.07 with a rising marginal product, meaning that the country was still in the red transmission zone (Wibowo, 2021). In this zone, physical distancing measures shall not be eased.…”